CMS Price Transparency Data

Flu vaccine (high dose)

Facility: St Joseph's Hospital

Billing Code: 90656 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90656
Insurance Median: $64
Cash Discount Price: $72
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Flu vaccine (high dose) at St Joseph's Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Molina Healthcare	$20 - $43	N/A
Aetna	$20 - $70	N/A
Humana	$20	N/A
Sae Hospice	$20	N/A
Blue Cross Blue Shield	$20	N/A
Clear Spring Health of Illinois	$20	N/A
UnitedHealthcare	$22 - $100	N/A
Amish Community	$28	N/A
Caterpillar, Inc.	$38	N/A
Naphcare	$42	N/A
Celtic Insurance Company	$44	N/A
Meridian Health Plan	$45	N/A
Hopetrust	$50	N/A
Claim Doc	$50	N/A
Cigna	$53	N/A
Wellfirst	$64	N/A
First Health	$74	N/A
Healthlink	$85	N/A
Multiplan/Phcs	$85	N/A
Provider Network of America	$90	N/A
Healthcare Finest Network (Hfn)	$90	N/A
Current Health Solutions	$100	N/A
Mental Health Network	$100	N/A
Consociate Group	$100	N/A
Qtc Medical Group of Illinois	$100	N/A
Health Alliance Medical Plans	$100	N/A
Interplan	$100	N/A
Illinois Breast and Cervical Cancer Program	$100	N/A
Healthscope	$100	N/A

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $72.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90656.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Joseph's Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90656.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.